Tubular handling of fluid and electrolytes during ovine pregnancy

Abstract

Pregnancy is characterized by progressive water and sodium accumulation and increases in renal blood flow (RBF) and glomerular filtration rate (GFR). However, the influence of the different nephron segments on the increased tubular reabsorption is controversial. Consequently, four nonpregnant and five pregnant sheep were studied, after chronic instrumentation, to assess salt and water reabsorption in the proximal and distal tubules under basal and volume-loaded conditions. Lithium clearance was used as a marker for proximal tubular reabsorption. Volume loading was achieved by the rapid administration of 1,000 ml isotonic saline followed by 250 ml/h for 2 h. Under basal conditions with reference to the nonpregnant state, pregnant sheep had higher (P < 0.05) levels of right RBF (427 +/- 34 vs. 313 +/- 8 ml/min), GFR (133 +/- 7 vs. 94 +/- 9 ml/min), proximal tubular reabsorption (102 +/- 7 vs. 73 +/- 6 ml/min), distal nephron fluid delivery (31 +/- 2 vs. 20 +/- 2 ml/min), and fractional distal nephron reabsorption of fluid (92 +/- 2 vs. 87 +/- 1%) and sodium (98.8 +/- 0.3 vs. 97.0 +/- 0.7%). However, pregnant animals had significantly (P < 0.05) reduced fractional excretions of fluid (1.6 +/- 0.3 vs. 2.6 +/- 0.2%) and sodium (0.24 +/- 0.06 vs. 0.63 +/- 0.19%), but similar levels of filtration fraction, fractional proximal tubular reabsorption, urine flow, urinary sodium excretion, and osmolar and free water clearance. After saline loading, pregnant sheep excreted significantly (P < 0.05) less sodium (9.2 vs. 28.6%) and water (39.8 vs. 56.5%). Decreases in fractional proximal and distal nephron reabsorption of sodium and water after saline loading were attenuated in pregnant animals.(ABSTRACT TRUNCATED AT 250 WORDS)